Manejo del dolor oncológico en paciente con cáncer de mama metastásico.

Intrathecal infusion therapy is indicated for refractory chronic pain, regardless of its origin (oncologic or not). Morphine and ziconotide are the only drugs approved for use as intrathecal analgesics. The addition of local anesthetics slows the escalation of opioid doses. We present the case of a woman with stage IV breast cancer, with multiple dorsal vertebral metastases, evaluated by the Chronic Pain Unit for severe, disabling pain refractory to conventional measures. An intrathecal pump of morphine and bupivacaine was implanted after a positive intrathecal test dose. Afterward, she had excellent pain control with full functional recovery and no need for adjuvant medication, regardless of disease progression. The use of intrathecal infusion therapy has become a safe and effective tool to consider in cases of refractory oncologic chronic pain. [ABSTRACT FROM AUTHOR]